Eair Pain / Pressure Relief

SixPapaCharlie

SixPapaCharlie

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Took our first family flight in the new plane yesterday and It couldn't have been more perfect.

Until we started our descent back home

It was night, ATC was busy, There was a 150 hobbling back on one magnito and my little girl starts screaming. I mean she was in major pain.
I am struggling to not be a dad at this point and just be PIC (That is hard) I wanted to climb back up, hold her hand, and tell her sweet things but I hit the iso switch to put her on ignore.

I could hear her screaming still just in the plane as we got lower and lower on final. You just want to reach back and hold their hand or something.

She is at this point too young to understand a valasalva. We tried but she just held her nose and blew air out her mouth (which was funny. I mean "hold your nose and blow"... She did.) We gave her gum thinking swallowing would help but no dice there.

I know she was having sinus issues earlier in the day but it has been years since I have had that experience. I recall having major ear pain as a kid but that was on SWA so we are talking what 8k feet pressurized?

Last night we were 5500 descending to ~1000 field elevation. She is not a drama queen so I know she must have really been hurting.


Any tips for little ears on planes?



On the flight out she slept so it was pleasant. Gave big brother a chance to have some fun w/ the selfie too.

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That's rough and I don't know what I'd do either.

Did they finally pop and she got some relief?
 
Yeah, that would be tough. How fast was your descent? I try to keep mine around 500 fpm or less if possible to reduce the pressure on the ears.
 
When we landed, she jumped off the wing and laid down on the ground.
Mom carried her to the FBO while I closed up shop and when I went to get them she was giggling.

My descent was a start & stop between 400-600 fpm ATC was doing the step down under the bravo thing so 4500, 3500, 2500, at your descression.

So it was down, level, down level, down level versus gradual
 
Maybe carry a bottle of water next time and tell her to drink? ....
 
txflyer said:
Maybe carry a bottle of water next time and tell her to drink? ....
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That's not a bad idea.
Pretty much the same idea as the gum only more swallowing and quicker.


noted.
 
Well, it sounds like there really isn't much you could have done different. I will thank you for the wake up call to be alert to sinus problems in the kids though. I have been lucky so far not to have any problems with my kids. I flew once having a mild sinus issue myself and it definitely got worse, so I feel for your little girl.
 
JasonM said:
Well, it sounds like there really isn't much you could have done different. I will thank you for the wake up call to be alert to sinus problems in the kids though. I have been lucky so far not to have any problems with my kids. I flew once having a mild sinus issue myself and it definitely got worse, so I feel for your little girl.
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As an adult, I haven't had this issue, and I have allergies, sinus, what have you.

I do remember being a kid and it being excruciating.
I recall SWA would give me warm coffee cups to hold over my ears.

In hindsight WTF was that???

But they did. It didn't do anything as far as I recall.
 
SixPapaCharlie said:
That's not a bad idea.
Pretty much the same idea as the gum only more swallowing and quicker.


noted.
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Maybe. Just be ready to land because you know what they have to do after drinking water ... :lol:

The thought hit me maybe chocolate milk because it's thicker and swallow's harder, but lord help you if she spills it in that nice Cirrus...
 
Bryan:

I feel your pain. My girlfriend has an 8 and 11 year old and neither of them appear to be able to reliably equalize the pressure. We've tried gum, snacks, water, describing how to equalize, etc. Just last flight, the little guy finally went "OH, MY EARS POPPED". It was clear he had never had that experience before, which is telling. I am hoping now he'll get the hang of it. The girl has somewhat chronic stuffiness and some alergies so that probably doesn't help.

They were in tears after descent and landing on our last flight, but the pain quickly subsides. My current idea is to give the girl at least a mild antihistamine in case that helps the stuffiness and the ear clearing.

Otherwise I have run out of ideas.
 
txflyer said:
Maybe carry a bottle of water next time....
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lol I went to a Dog Bar the other day where they have water bottles for when a dog gets a lil feisty they squirt the dog, so yeah, when ur lil girl starts screaming, bust out the water bottle!

so, when you say 'ear pain', did you mean YOUR ears hurt?!?

anywho, I don't have kids but sounds like you need extra flight planning for 'worst case scenario', such as screaming crying kids that are thoroughly distracting you from PIC duties. not to sound unsympathetic, but u got sht to do.
 
It's easy to look back and say you should have gone. But once it starts, you have to deal with it. Yawning can help your ears pop. For a kid in pain it's tough to do, though. Taking a big, quick gulp of water can get a swallow going that can sometimes help. Some people say chewing gum works, but it never did much for me.
 
Two things....teach the little one about the valsava - but make sure she understands it. Next, not hot coffee but hot water in a cup next to the ear. Learned this one decades ago on AA or United or Continental, never remember which. The air above the hot water and steam changes the air pressure and just enough to help with the ear pressure. Free hot water isn't the best idea for a little one, but pack a washcloth in a baggie with hot water. Then when the little starts to have ear problems, the warm cloth against the ear will help.
 
I have a sister with very sensitive ears.

The only thing that helped was when Dad bought a pressurized airplane. That solved it once and for all.
 
In addition to the above ideas, if the pain is in just one ear, have her tilt her head looking slightly up and back so the affected ear is on top, allowing a slight stretch of the tube. Then yawn and work the jaw to get the equalize to happen.

This is what I do when scuba diving and descending with my hands full of camera or other gear, allowing me to equalize during descent without pinching my nose.

And good on you to be PIC during this stressful moment. But also remember this, you were VFR. And unless you had a limited fuel constraint, you could have easily told ATC that you need to do a 180 and climb back to where Li'l 6PC's pain started. Then once there, start a gradual descent to help her clear her ears. Once below the Bravo shelf, you can head toward the airport.
 
Yep, I +1 the "open your mouth as wide as you can and then try and yawn". I bet that fixes it right up. Plus it doesn't require hot steaming liquids, extreme head turning that could make the headset come off or shift off her ears, or sticky gum to choke on while crying her eyes out.
 
One of the worst pains I've ever felt was the day I decided to take sky divers up when I had a sinus infection. I wasn't aware of my sinus's being in that bad of shape.

Kicked the divers out at 11,500 and went into my normal steep bank high rate of descent profile (somewhere around 3 to 4 k a minute) over top of the airport and a few seconds later thought my head was about to explode. I figured it would pop and go away quickly and kept the descent up. A little bit later and OMG.

Slowed the descent WAY down and took my sweet time getting back to the airport and said I was done for the day. Was unbearable for a few hours.
 
Well I know what I would have done. I would not have continued to descend if someone was having ear pain from not being able to equalize the pressure. It just makes it worse, and also harder to do anything about oneself.

I don't fully understand the anatomy but apparently it is virtually universally easier to equalize on ascent than on descent, hence the need for Valsalva maneuvers or yawning/swallowing when descending from altitude. On ascent, the pressure differential tends to force open the eustachian tube spontaneously. On descent, this does not happen, and once a significant negative pressure differential has built up, it becomes more and more difficult to open the passageway. I have this problem myself from time to time and always carry an oxymetazoline-based nasal spray with me when flying. In fact, I use it prophylactically whenever I'm going to be cruising at altitudes more than about 4000 above the departure field.

If you want to continue to take your girl flying, you'll have to teach her how to equalize the pressure. If yawning works for her, best is to start doing it BEFORE descending, to help stretching the tissues so they don't get locked shut when the pressure starts increasing. Carry along a bottle of nasal spray (Afrin or drugstore generic). If nothing is working, then climb back to cruise altitude, treat her, and wait AT LEAST 10 minutes before starting to descend again. And this time, come down gradually, no more than 500 fpm or so as an average rate. (I've also found that descending in steps of 1000-2000 feet, waiting a couple of minutes between steps, is easier to deal with than a continuous descent of 500 fpm, but maybe that's just me.)

Ear pain on descent is nothing to take lightly -- if the pressure inequality is great enough and persists for too long, fluid will effuse into the middle ear space that can take several days to reabsorb. In the meantime, she'll be VERY uncomfortable.
 
JasonM said:
One of the threads I just came across mentioned doing a 200 fpm decent for someone in this situation.
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Good advice. (But just FYI: "Decent" is an adjective that refers to goodness. It rhymes with "recent". "Descent" is a noun that refers to lowering. It rhymes with "intent".)
 
acrophile said:
Good advice. (But just FYI: "Decent" is an adjective that refers to goodness. It rhymes with "recent". "Descent" is a noun that refers to lowering. It rhymes with "intent".)
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And "eair" isn't a word but "ear" is. And it rhymes with "beer".
 
anything that causes chewing and swallowing can help the eustachian tube (in the throat that "vents" the middle ear) to open and the ear to equalize pressure.

Allergies and/or colds can cause inflammation in this tube.....which doesn't allow fluid or pressure relief for the middle ear.

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Slight correction -- it's the middle (not the inner) ear that is connected to the throat via the tube.

But, you brush up against an important point: Specifically, changing unequalized pressures, particularly if coupled with forceful Valsalva maneuvers, can rupture a small membrane leading to the inner ear. This is a far more serious phenomenon than pain due to stretching and swelling of the middle ear or even a rupture of the ear drum. The phenomenon is rare in flight, but there are some documented cases involving flight attendants.

Checkout_my_Six said:
anything that causes chewing and swallowing can help the eustachian tube (in the throat that "vents" the inner ear) to open and the ear to equalize pressure.

Allergies and/or colds can cause inflammation in this tube.....which doesn't allow fluid or pressure relief for the inner ear.

h9991410_001.jpg
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Don't forget sinus issues, too. Even a slight cold or congestion can not only cause ear pain, but some pretty sharp sinus pain, too.

During my PP training, my CFI stressed pax comfort - "You are the pilot, act like a professional so your passengers think you know what you are doing." That included keeping descents no more than 500fpm unless necessary. Apparently that's a good descent rate to minimize ear problems. Sometimes that's even too much.

But it's like scuba diving in some ways. The longer you stay at a certain altitude, the more your ears get adjusted to it. If you have any kind of congestion at all, even a slow descent might be too much for them to equalize quickly enough. Stepping down a little at a time could help in that case. Your ears are kind of a slow moving altimeter - keep pressure on each side of the ear from changing too quickly, but if there is a plug in the line there will be problems.
 
I wonder if a prophylactic dose of an antihistamine, like Sudafed, would be helpful in keeping everything open?
 
Both kids' allergies have been bad this week. I've been giving them allergies meds in the morning, but it doesn't seem to help with Brooke's sinuses. I think the answer is not taking her flying when we know she's dealing with that.

Or maybe we bring some of the cookies along from the FBO. That's what got her smiling once we were back on the ground. :yesnod:
 
The results of the relevant studies are not as compelling as you might think.

Checkout_my_Six said:
I wonder if a prophylactic dose of an antihistamine, like Sudafed, would be helpful in keeping everything open?
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Checkout_my_Six said:
I wonder if a prophylactic dose of an antihistamine, like Sudafed, would be helpful in keeping everything open?
Click to expand...
Just a slight correction in that Sudafed is a decongestant, not an antihistamine. My mother had problems clearing her ears when flying commercially and her doctor suggested Sudafed before flying, and also some sort of inhaler (this was a LONG time ago so I don't know what was in the inhaler). I only took her flying a couple times in small airplanes but I was careful not to get much above 3,000' AGL.
 
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The inhaler may have dispensed sodium cromoglycate. It's great stuff but in powdered form makes a proper mess in my Ebbinghausian beard.

Everskyward said:
Just a slight correction in that Sudafed is a decongestant, not an antihistamine. My mother had problems clearing her ears when flying commercially and her doctor suggested Sudafed before flying, and also some sort of inhaler (this was a LONG time ago so I don't know what was in the inhaler). I only took her flying a couple times in small airplanes but I was careful not to get much above 3,000' AGL.
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islandboy said:
The inhaler may have dispensed sodium cromoglycate. It's great stuff but in powdered form makes a proper mess in my Ebbinghausian beard.
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That avatar picture was hard to make out, so I had to enlarge it:
 

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I think the real takeaway here is, "don't have kids."
 
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